Counselling Vietnamese refugee survivors of trauma: 

Points of entry for developing trust and rapport

by Tiep Nguyen and Robin Bowles

What approaches should health and welfare professionals adopt when working with Vietnamese survivors of trauma? STARTTS counsellors Tiep Nguyen & Robin Bowles share some of the knowledge they have acquired in the past decade.

If you can enter your clients’ worlds for a time and join them on their journey, you may find a new understanding and respect for how their worlds are different from your own. (Ivey, Ivey and Simek-Morgan, Counselling and Psychotherapy - A Multicultural Perspective,1993, p.2)

Many authors have pointed out that establishing trust with survivors of trauma is a central issue in successful counselling. This article examines three aspects of establishing trust with Vietnamese clients, which we have been examining in our clinical practice: self-presentation of the counsellor; approaching a problem and working through an issue.

Self-Presentation of the Counsellor

In our experience, we have found that the style and presentation of the counsellor is important for building trust with people from a Vietnamese culture. The complex dimensions in the concept of ‘culture’ are discussed more fully in the longer published article referenced below.

The style and presentation of the counsellor could be described as ‘being a friend’ to our client. ‘Being a friend’ does not at all mean that we should drop our professional role with boundaries and ethics, but rather means that we should be caring, sharing and acting as a true friend would normally be.

Communicating caring to Vietnamese clients is being friendly, warm, interested in family, attentive to concerns raised, being an empathic listener, trying to understand and respond to non-verbal communications, and being ready to assist with practical matters.

Presenting ‘as a friend’ also means that we, counsellors, may initially have to share, or disclose, a little more about ourselves than usual. This is often necessary to put Vietnamese clients at ease and win their trust.

Another dimension of being a ‘friendly’ counsellor is being a ‘friend in need’. Many counsellors of Indochinese refugee clients have found it vital to assume multiple helping roles and to be actively involved in providing them with practical assistance or concrete services that provide immediate results, before engaging them in dealing with past trauma or in making important self-disclosures.

Approaching a Problem

The success of establishing trust and rapport with Vietnamese clients is not only dependent upon the way the counsellors present themselves as described above, but also upon the way they approach a problem.

Within Vietnamese culture there are distinct ways of dealing with problems. Prominent features of the Vietnamese style include indirect expression of feelings, reluctance to confront conflictual situations, preference for allowing time to work out seemingly insoluble problems, and reliance on personal inner strength in facing difficulties.

Given the quite different ways of dealing with problems in Vietnamese culture, we would like to suggest that non-Vietnamese counsellors have to move slowly and gently and approach with the right timing.

Following a respectful, slow pace suitable to the client is important, especially during the rapport building stage, to avoid jarring or offending the client. The timing of approaching the problem is important for maintaining the relationship and for resolving the problem. If the counsellor takes the initiative to bring up an issue, it is important to do this gently, keeping in mind the cultural norm of ‘saving face’ and the risk of confrontation.

Working through an Issue

As issues begin to be worked through, we suggest three ways of continuing to build rapport and trust with Vietnamese clients: working with somatisation, working from here and now and working through the family.

A great number of Vietnamese refugees express their experience of emotional distress under the guise of physical symptoms such as headache, fatigue, insomnia. As somatisation is a culturally acceptable way of presenting mental problems, counsellors can work with these problems first, before moving onto deeper levels.

Most Vietnamese refugees are concerned with day-to-day survival. Offering them practical assistance is seen as offering much needed help and assisting to set up a trusting relationship and also an external environment in which emotional issues can be more safely worked through.

For Vietnamese, the family plays an important role, in a resettlement country as well as in their country of origin. It appears to be present and influential in many issues, which the Vietnamese client discusses in the session. It has been pointed out that the family can support or sabotage the relationship between the therapist and the patient. Therefore, in post-trauma counselling with Vietnamese clients, dealing with the family dimension is crucial for the building of trust and understanding and for the success of the intervention.

It is hoped that this article can contribute some suggestions for successful building of trust between Vietnamese-born clients and their counsellors. Points of entry rather than barriers have been emphasised in three aspects of counselling. Credibility and giving are seen as being crucial in this process.

No counsellor need feel afraid to travel along with Vietnamese refugees on the road to recovery from trauma. Vietnamese refugees have a great need for company, because they have suffered multiple losses, including faith in the goodness of humanity. Through a counsellor establishing a trusting relationship with them, they could regain this faith, so as to cherish the life that they have sacrificed everything for.

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* This is a reproduction of part of a longer article with the same title, by the above authors, published in the Journal of Australian Social Work, June 1998.